Vermont advocates call fee a danger to inmate health

According to Pennsylvania's policy, where 279 Vermont inmates are housed, there is a $5 fee for certain non-emergency medical services. Advocates say this causes health and inequity concerns.
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Shown is the the front sign at the State Correctional Institution at Camp Hill, Pennsylvania, where some Vermont inmates are housed.(Photo: Marc Levy, AP)

Vermont inmates out-of-state are charged $5 for some medical services. Inmates in-state are not charged a fee.

Advocates and lawyers say that the co-pay could act as a disincentive for inmates to seek medical attention. This could turn into a public health problem for the general population of inmates and guards, said Vermont Defender General Matt Valerio.

Valerio said the problem is that many inmates, if forced to make the choice between paying $5 for medical treatment or buying comfort items through the prison, would likely forego treatment.

"This, at times, has inmates ignoring the flu and mononucleosis and staph infections and other types of things that can be very dangerous in a closed situation," Valerio said. "By the time treatment is finally received, the issue could be acute or could spread a disease within a facility."

Tom Dalton, executive director of Vermonters for Criminal Justice Reform, said these poor health outcomes could also affect taxpayers' wallets.

"It is likely to end up with extra costs to the taxpayers in the long-run because if people ignore medical symptoms because they don't have the money for the co-pay or they're not willing to use what little money they have on the co-pay, the untreated medical condition can become an emergency," Dalton said.

Pennsylvania Department of Corrections spokeswoman Amy Worden said the money collected through the co-pay doesn't even begin to cover the cost of health care for 48,000 inmates in Pennsylvania's prison system.

"But, it is a small way to try to reduce frivolous medical complaints," Worden said in an email. "No one is denied care if they cannot afford their co-pays."

Vermont Department of Corrections Deputy Commissioner Mike Touchette said there is no way for Vermont inmates to predict having this expense since moves to Pennsylvania are not disclosed to the inmates until right before they leave, for security reasons.

"It's a new process that Vermont inmates in Pennsylvania are adjusting to," Touchette said. "It's not unlike a citizen in the community, though, where if you require a visit with a doctor, there's a co-pay. So, there are some real-life implications here about responsibly managing money and using it for items that are most important."

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Mike Touchette, the Department of Corrections' Director of Facility Operations, discusses the recent hostage-taking situation at the Northern State Correctional Facility in Newport during an interview in Waterbury on Thursday, September 15, 2016, (Photo: GLENN RUSSELL/FREE PRESS)

As of Tuesday, 279 Vermont inmates are being housed at Pennsylvania's SCI Camp Hill, Touchette said. Vermont has a three-year contract with the Pennsylvania Department of Corrections since there is not enough room to jail all Vermont inmates in Vermont.

Chloe White of the American Civil Liberties Union in Vermont said the organization is looking into whether the payment inequity is a Vermont constitutional concern. Vermont prisoners in Pennsylvania are under an interstate compact, which means they must abide by Pennsylvania's policies.

"Legality or constitutionality aside, we think it’s problematic to have to pay for necessities like this and unfair that there are different standards for different prisoners, which is why we need criminal justice reform so we can cut the prison population and bring inmates back to Vermont," White said in an email earlier this month.

According to Pennsylvania's policy, inmates are asked to pay the $5 fee for any non-emergency medical services provided at the inmate's request or medical services needed when the injury or illness is self-inflicted, arises from an inmate's participation in a sport, or when the inmate is found guilty of misconduct for the assault or injury of another inmate.

Inmates can also be charged for some initial prescriptions and any medical services provided to determine physical fitness for participation in a sport, work, housing or medical status.

Tom Dalton(Photo: Courtesy Suzi Wizowaty)

The policy states that the co-pay is waived for inmates seeking medical treatment or needing medication for chronic medical diseases or illnesses requiring regular visits as specified by a medical provider, mental health treatment, long-term care for inmates, services provided during a medical emergency, and more. Touchette said inmates too poor to pay are also not charged, but he was unsure how many Vermont inmates were classified that way.

"At the conclusion of the visit, the health care staff shall inform the inmate whether a fee will be charged for the medical service provided," the policy states.

Those who are charged but cannot pay right away will have their account debited once they can pay, according to the policy.

The Vermonters for Criminal Justice Reform Facebook post quoted a letter from an inmate saying another inmate was going to stop putting in sick call slips because the prison took $15 from his account already. The inmate only had $15 in his account to begin with, the post stated.

"Usually people who are incarcerated don't have much money at all, if any," Dalton said. "A lot of people don't have family or anyone on the outside to send them money."

Dalton said there is a limited number of jobs for Vermont inmates in Pennsylvania, which makes it difficult for them to earn money. Touchette said that as of a month and a half ago, about 50 Vermont inmates had jobs at Camp Hill. He said he didn't have updated numbers as of Tuesday.

Worden said Vermont inmates are currently holding jobs on various housing units, in addition to painting murals in the institution and working in food service. She added that all inmates in Pennsylvania who have been incarcerated for at least 60 days receive general labor pool money if they are not assigned to a job.

According to Pennsylvania Department of Corrections' inmate compensation policy, inmates can be paid anywhere from $0.19 to $0.42 per hour depending on their job and skill classification. Work hours range from four to seven hours per day, five days per week, Worden said.

Inmates who are unable to work due to a medical condition are eligible for a medical allowance of $0.50, five days per week, the policy states.

Other expenses for inmates could include making phone calls or buying items from commissary. Touchette said Vermont Department of Corrections provides its inmates with seven stamps per week to write letters, and Pennsylvania Department of Corrections officials provide inmates with other essentials such as shampoo and soap.

Touchette said there is no plan at this point to implement a copay in Vermont or to repay Vermonters who have had to pay Pennsylvania's copays.

Valerio said the Defender General's Office, which includes Prisoners' Rights, would have to look into what potential actions could remedy this issue for out-of-state Vermont prisoners.

Vermonters housed at a state prison in Camp Hill, Pennsylvania are charged for some medical services, while in-state inmates are not.(Photo: Carolyn Kaster, ASSOCIATED PRESS)

Vermonters for Criminal Justice Reform has encouraged people to ask Gov. Phil Scott's office end the out-of-state contract.

"In Vermont, we want a justice system that values fairness and equity and teaches those values to the people who are serving sentences for crimes," Dalton said. Referring to the interstate compact, he added, "In effect, the (Vermont) Department of Corrections has surrendered Vermont's ability to influence policy over Vermonters and to implement policies that are in the best interests of Vermonters, and I think that's a serious problem."

Contact Elizabeth Murray at 651-4835 or emurray@freepressmedia.com. Follow her on Twitter at @LizMurrayBFP.